No Need for Restraints
October 11, 2007 by Kristina Chew, PhD
Filed under Health
64-year-old Mamie Hubbard-Washington, a special education teacher in Las Vegas, is alleged to have pinched, pushed, and verbally abused her students, some of whom have autism and do not speak. Parents testified on September 26th that their children came home with bruises from Hubbard-Washington’s classroom at Reed Elementary School.
In Racine, Wisconsin, a 3-year-old autistic boy was restrained in a Rifton Toddler Chair with belts, without his parents’ knowledge or consent. Hasmig Tempesta only learned that her son, Zachary, was being restrained in this manner after an in-home therapist observed Zachary at school.
I do not know what any of the students mentioned in these news stories were doing, so that teachers decided to use the belts and chair, or, in Hubbard-Washington’s case, may have physically harmed a student. I do know that my son had a tough day today at school—intermittent and completely sudden jags of crying and yowling, throwing his lunch (the rice he usually digs into), grabbing at his teachers—a week of half-days and the weather going from record-setting 80-plus degrees to 63 right now in just a few days could have something to do with it.
Charlie’s teacher wrote to me as soon as school was over about the day and I am quite sure that she is thinking of how to change things in Charlie’s day tomorrow. Also, because we have a lot of information about Charlie’s behavior difficulties in the past, his teachers and therapists have plans and are ready to use them at a moment’s notice—instead of belting a child in a chair, or ending up in court.
My son was often restrained at his first school. I took him out.
And only yesterday i was told i should restrain him in the shower!!
There are other options, all it takes is some thought.
I don’t know what I would do if I found out my son was being restrained…but I’m sure it would involve temporary insanity!
Apologies in advance for length, and for discussing some issues beyond this particular story.
Let me frame the possibility, that sometimes these things might be used even before there is a need. The first day of my daughter’s attendance in a brand-new autism program (at our University (!)), there were 2 rifkins in a classroom with no CP students or other orthopedic needs. We walked in and the moment that my daughter sat down in a regular classroom chair to do a puzzle, the aide reached down to strap on seat-belt straps. The aide looked genuinely puzzled when I asked her what the heck she was doing.
I looked around and all the kids had these straps on, in a 1:1 classroom. Mechanical restraint was part of the routine, and they really didn’t understand why there might be a problem with that. We had a rather unpleasant discussion with director and teacher, but it kept the belts off of our daughter, or at least for the two months before we could negotiate a more appropriate placement. The rifkins, as it turned out were reserved for when a kid was being “really inappropriate”. “Really inappropriate” translated, in one instance, to getting up twice during circle. As several statements in the WI paper indicate from various groups, this is STILL an unintended and inappropriate use of the chair.
I thought that this might be unique (BTW–we are not in WI), but subsequently on our local lists I found that routine mechanical restraint was going on in different places and classrooms, and the consensus was that while it might keep a kid in one spot, it didn’t necessarily seem to be doing much towards motivating sitting or encouraging a timely consideration of environmental modifications so that a child might learn to want to. On checking with the local disability advocacy center, I learned that except in emergency under defined conditions, restraint should require a behavior plan, and in that case the parents should receive written notice and participate in the development of that. The comment there was also not to be fobbed off with the platitude that it is “educational restraint”. That may be a belief by the person using it, but it is not a legal or valid definition.
A few years down the road, I hope that with better knowledge of motivation and positive pairing and the direct and collateral dangers of restraint, I could say it was getting better as a whole, but I am on a restraint list, and there are plenty of posts with unfortunate news stories. As was noted in a recent post on this blog–inappropriate restraint can lead to trauma, injury and death. As also noted, there are alternative and better ways to the end result of attending.
My understanding from those long involved in the study of restraint is that a lack of statute is not necessarily unique to Wisconsin. In many states there are more regulations on conditions of and training for use of restraint on the mentally ill and those in institutions than for children on IEPs. That is why if one is really concerned, that it might make sense to inspect your state regulations and work for legislation if there is lack therein. Our state recently had a public review of the regulations and I, among many others, submitted comments and additional information from TASH and CAICA. Fotunately the public response seems to have resulted in some improvements on conditions of use, training, reporting and adherence to parental notification. If you are interested in the question, I would check out the TASH, CAICA websites and perhaps join the RESTRAINT_INFO yahoogroup.
Plans are essential. Training is, too. Even if a child has the potential to melt down seldom, the plan needs to be in place for those few times.
Dec. 24, 2007
“RACINE — State education officials determined that teachers in the Unified School District improperly restrained a young boy with autism, according to the results of an investigation…DPI officials, during the course of the investigation into the district’s use of the chair in special education classes, learned that several schools in the district used the Rifton chair inappropriately with certain students…The chair is not intended to be used with children as a behavioral restraint, state officials said.
Classroom teachers and special education aides lacked adequate training regarding positive behavior interventions, sensory integration and the very limited circumstances under which the use of restraint is appropriate, state officials determined…”
http://www.journaltimes.com/articles/2007/12/24/local_news/doc476f43e96ae24159149085.txt
Just put up a post about this—–the mother’s last words really rang in me.
I just thought I’d put another perspective on this. It is true that if you have a wrench but not a hammer in your tool kit, you are likely to pound nails with the wrench, and that if you have a hammer, you are likely to find things to pound on. However, just because a number of us choose to support particularly challenging kids, that doesn’t mean that we are all restraint happy. I am the trainer of restraints for my program, but the heavy emphasis is on how to avoid this by supporting students with what they actually need. I have been teaching bite releases for years, but have never used one. Unless we are in actual danger of losing a body part, the usual response by a staff member who happens to get to close to someone with a sensory need is to wait until the bite is finished. Furniture and objects are heavily chewed, but in my years, I have only seen one bite between students. The injuries that we see are related to the depth of need/ not the lack of proactive steps. Moreover, all the serious injuries (concussions, injuries requiring surgery, etc) occur to staff, not students. Restraint should always be a last resort used only when the danger of not implementing it is greater than the danger of using restraint. There are actually a whole bunch of us out here who not only think like that, but act like that. And yes, many of us are parents too.